Resident History

Have you or your spouse ever been arrestedand/or convicted of any misdemeanor or felony?

When:

Type of arrest/conviction:

Have you or your spouse ever filed bankruptcy or are eitherof you presently involved in an active bankruptcy case?

When was the bankruptcy filed?

Where was it filed?

Resident Employer

Name: *

Phone Number: *

Address:

City: *

State: *

Zip:

Position: *

Monthly Salary: *

Supervisor:

Employed here from:

To:

Spouse's Employer

Name:

Phone Number:

Address:

City:

State:

Zip:

Position:

Monthly Salary:

Supervisor:

Employed here from:

To:

Vehicle Information

Make: *

Model: *

Color:

Year:

License #: *

State: *

Make:

Model:

Color:

Year:

License #:

State:

Persons to Occupy Apartment

Name: *

Relationship: *

Date of Birth: *

Name:

Relationship:

Date of Birth:

Name:

Relationship:

Date of Birth:

Name:

Relationship:

Date of Birth:

Emergency Contact

Name: *

Relationship: *

Email Address:

Home Phone: *

Work Phone: *

Address:

City:

State:

Zip:

Terms of Application For Lease

Security Deposit is hereby acknowledges as a non-interest bearing deposit and not a rental payment. If for any reason the management decides to decline the applicant, management will refund the security deposit in full. Once the application is approved, the applicant must cancel within 72 hours in order to receive a full refund of their security deposit. Cancellations after 72 hours will result in automatic forfeit of the entire security deposit.

The applicant hereby authorizes Brookside Properties Inc./ Brookside Agent to conduct a credit check that includes, but does not limit to, obtaining a credit report and interviewing the applicant’s references and previous landlords. The applicant hereby consents to the credit check process and authorizes any individual listed in this application to speak with Brookside Properties Inc./ Brookside Agent regarding the applicants present or previous credit performance. Applicant further release any and all individuals who provide information to Brookside Properties Inc./ Brookside Agent from any and all claims which the applicant may have resulting from information provided to Brookside Properties Inc. / Brookside Agent. The applicant also authorizes the release of information based upon reliance of either photocopies or facsimiles of the authorization. The undersigned applicant certifies that the above information is true and correct and hereby authorizes verification of same. Any false information in the application shall result in immediate denial of application and or termination of any lease resulting from acceptance of this application. If accepted as a resident, this application is to become a part of the lease file. All information provided will be kept in confidence.

Further processing of this application may be subject to fees.

I Agree To Abide by the Terms and Conditions of this Application for Lease as Stated Above.